Since 1973, contraception has been a hot political debate.
Health care provider "conscience clauses," also referred to as "refusal clauses," initially came about in reaction to the 1973 U.S. Supreme Court's groundbreaking Roe v. Wade case. This case determined that in the U.S., the majority of cases against abortion infringed on an individual's right to privacy under the Constitution, and thereby overturned all state laws denying the procedure. Since then, both former President Bush and President Obama have intensified the debate over abortion laws with their individual actions on the matter.
Defining "Conscience Clause"
Following Roe v. Wade, some states enacted laws that allowed health care workers the choice of whether to provide a patient an abortion. Recently, the issue has picked up momentum as pharmacists are even denying patients both prescription and emergency contraception. A "conscience clause" allows pharmacists the right to withhold contraceptive care founded on a violation of their own personal morals.
President Bush Defines
In 2008, the Bush administration coined "conscience" rule to mean that as long as a worker believes that his religious or moral beliefs have been infringed on because of a patient's health care practice or prescription, he is able to refuse the patient care. The rule also allows for hospitals and insurance companies to refuse care.
President Obama Responds
In February 2011, President Obama declared that contraception is not abortion, disallowing health workers such as pharmacists, hospitals and insurance companies from refusing patients care.
Contraception, Nonsurgical Abortion and Pharmacists
As clarified by the Association of Reproductive Health Professionals, medical or nonsurgical abortion stops an already existing pregnancy. It is administered to females up to 49 days' gestation; it terminates the pregnancy by obstructing the hormones essential to advancing a pregnancy. Emergency contraceptive pills, on the other hand, assist in the prevention of pregnancy. Maximal effectiveness of these pills is reached if they are taken 120 hours -- five days -- or less following unprotected sexual intercourse. Emergency contraception works in a variety of ways depending on where a woman is in her menstrual cycle when it is taken. It may prevent ovulation, restrict the egg or sperm from being carried to the uterus or alter the uterine lining, inhibiting a fertilized egg to implant itself. While pharmacists do distribute emergency contraceptives such as Next Choice™, Plan B® One-Step and ella®, nonsurgical abortion is most commonly sold under the brand name Mifeprex® in the U.S. and is not administered by them.
Ongoing Legislation
Since the Obama administration's 2011 revisions, legislators in Arkansas, Georgia, Idaho, Mississippi and South Dakota have enacted laws giving pharmacists the right to outright deny emergency contraception to patients. In April, the Missouri House endorsed a measure, too, granting pharmacies permission to refuse to provide emergency contraception assistance. The Missouri Senate has yet to act on it.
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